Development and Validation of a s Standardized Video-Based Assessment of Movement Quality in Breast Cancer Survivors

Purpose Cancer survivors frequently experience persistent movement inefficiencies and coordination deficits following cancer treatment, which may not be fully captured by commonly used performance-based mobility tests. The purpose of this study was to develop and validate a clinically feasible, video-based assessment designed to characterize movement quality in cancer survivors. Methods This cross-sectional validation study included 70 breast cancer survivors recruited from outpatient rehabilitation clinics. The Rehabilitation Movement Assessment Protocol (ReMAP) consists of standardized, sequential, and unfamiliar functional tasks designed to elicit real-time sensorimotor control demands. Movement quality was quantified using kinematic metrics derived from markerless video-based pose estimation, reflecting postural stability, motor control, inter-limb coordination, and movement efficiency. Construct validity was examined using correlations with clinical reference measures, and within-session internal reliability and measurement error were evaluated. Results ReMAP-derived kinematic metrics demonstrated distinct associations with conventional mobility measures, supporting construct distinction between movement quality and task performance. Reliability varied across movement quality domains, with coordination and motor control metrics demonstrating higher reliability than postural sway measures. Measurement error indices were within acceptable ranges for clinical assessment. Conclusions The ReMAP Assessment provides a feasible approach for quantifying movement quality in cancer survivors and captures functional characteristics not readily identified by performance-based mobility tests. These findings support the use of ReMAP as a movement phenotyping tool in cancer survivorship research and rehabilitation practice. Implications for Cancer Survivors For cancer survivors, functional limitations often reflect inefficient coordination and altered movement control rather than reduced task completion speed alone. By characterizing how functional movements are executed, the ReMAP Assessment provides clinically relevant information that may help identify subtle movement inefficiencies associated with fatigue and reduced functional confidence. This approach has potential to support more individualized rehabilitation strategies and improve functional participation in cancer survivorship.